Cemanahauc Educational Community

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On-line Application and Registration Form 2009

Application

All students pay a $95.00 non-refundable, one-time application fee at the time of submission.

Note: Students attending as part of a group should not use this form. Group members register through your designated Group Leader/Representative.

Are you a returning student?	yes no
Gender:	male female
Today's Date	mm/dd/yy
First Name
Last Name
Address 1
Address 2
City
State
Zip Code
Country
Home Phone
Work/Cell Phone
Email
Age
Birthdate	mm/dd/yy

A value is required.Invalid format.

Registration Form

Occupation:
If student, what school do you attend?
Date of first Monday at Cemanahuac:	mm/dd/yy
Number of weeks of study:
Location:	Cuernavaca Buenavista
Program:

Do you want to stay with a Mexican host family?	yes no undecided
Housing preferences:	double room single room Cemanahuac Guesthouse (Cuernavaca, only)
Date of Arrival in Cuernavaca:	mm/dd/yy
Date of arrival in family home/guesthouse:	mm/dd/yy
Date of 1st Monday in class:	mm/dd/yy
Date of departure:	mm/dd/yy
Any preferences or special needs? Please also state any additional information we may need to know.
Emergency Contact Information:	Name Phone Email Relationship

Your Cemanahuac Educational Community fees are payable at the time the language placement examination is taken at the school. Payment in travelers checks, cash, or personal check is preferred, but we do accept Visa and Mastercard for registration and tuition.

After choosing Submit, you will be asked to enter payment information for only the $95 Application/Registration Fee.